From the Guidelines
The DSM-5-TR criteria for nicotine abuse, dependence, or misuse is referred to as Tobacco Use Disorder, which requires at least 2 of 11 criteria occurring within a 12-month period, including symptoms such as using tobacco in larger amounts or longer than intended, persistent desire or unsuccessful efforts to cut down, and craving. The diagnosis of Tobacco Use Disorder reflects the addictive nature of nicotine, which causes neurochemical changes in the brain's reward system, particularly affecting dopamine pathways 1. The 11 criteria for Tobacco Use Disorder are:
- Using tobacco in larger amounts or longer than intended
- Persistent desire or unsuccessful efforts to cut down
- Spending considerable time obtaining, using, or recovering from tobacco
- Craving
- Continued use despite social or interpersonal problems
- Giving up important activities because of tobacco use
- Recurrent use in hazardous situations
- Continued use despite physical or psychological problems
- Tolerance
- Withdrawal symptoms
- Continued use despite knowledge of having persistent problems caused by tobacco. The severity of Tobacco Use Disorder is classified as mild (2-3 symptoms), moderate (4-5 symptoms), or severe (6+ symptoms) 1. Withdrawal symptoms typically include irritability, anxiety, difficulty concentrating, increased appetite, restlessness, and intense cravings, which often lead to continued use despite harmful consequences.
From the Research
DSM-5-TR Criteria for Nicotine Abuse, Dependence, or Misuse
- The DSM-5-TR criteria for tobacco use disorder, which includes nicotine abuse, dependence, or misuse, are not explicitly stated in the provided studies 2, 3, 4, 5.
- However, a study published in 2012 6 aimed to identify appropriate criteria for tobacco dependence assessment and evaluate relevant research to suggest revisions for DSM-5.
- The study found that DSM-IV criteria were ambiguous, little used in tobacco research, and had relatively low predictive validity 6.
- The authors suggested eliminating most DSM-IV criteria and adding new ones based on smoking pattern, smoking heaviness, and the severity of craving during periods of smoking and withdrawal 6.
- Some key dependence measures that were found to be useful include:
- Strength of urges to smoke on typical smoking days and during abstinence
- Markers of nicotine intake or frequency of smoking
- Latency to smoke soon after waking 6
- These measures may be relevant to the DSM-5-TR criteria for nicotine abuse, dependence, or misuse, but the exact criteria are not specified in the provided studies.